Interlocking intramedullary ulna nails in isolated ulna diaphyseal fractures: a retrospective study

Objective: The aim of this study was to evaluate the results of multifunctional intramedullary (IM) ulna nailing following diaphyseal fracture of the ulna. Methods: Adult patients with isolated fractures of the ulna treated with closed or mini-open reduction using the new IM ulna nail between May 2008 and January 2011 and who were followed for a least one year were retrospectively reviewed. Patients with a pathological fracture or nonunion after previous surgeries were excluded. Functional outcome was assessed using the Grace and Eversmann rating system, patient-reported outcomes using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Wrist flexion and extension was evaluated using a goniometer. Results: The 18 patients (13 male, 5 female; mean age: 28 years, range: 18 to 64 years) had a total of 20 isolated ulna fractures (two bilateral). Mean time to fracture union was 13 (range: 10 to 14) weeks. No patient had nonunion, deep infection or radioulnar synostosis. Follow-up time ranged from 12 to 36 months. Grace and Eversmann ratings were excellent in 15 patients, good in 2 and poor in one. Mean DASH score was 8.08 (range: 0 to 17.5) points. Conclusion: The new IM ulna nails may be considered an alternative method for isolated diaphyseal fractures of the ulna. Advantages of this method include its short operative time, insertion by closed and minimal invasive techniques, use of scope only in reduction and locking control, as well as minimal cosmetic defect, small operative scar and early mobilization without additional fixation.